Redrawing Democracy: How Structural Racism and Gerrymandering Undermines Health Equity for Minority Communities
One of the central facets of democracy is the voice of the people. That voice, funneled through elections, grants individuals the power to decide not only who represents them in government but also what policies will shape their lives. When formal and informal barriers limit a minority group’s ability to vote, their voices–and the needs they–risk being silenced too. Policies aimed at voter suppression have disproportionately put people of color at a disadvantage, including in terms of their health. This paper aims to explore the idea that fairness within our democracy is under attack from the laws and practices that we have normalized as a country.
What is Structural Racism?
Many are familiar with the idea of racism that operates at the individual level. Structural racism, by contrast, refers to the scaffolding –composed of laws, policies, norms, and rules–that institutionalizes the unfair treatment of people of color at the societal level. Camara Jones refers to this concept as “institutionalized racism” or “inherited disadvantage” that is normatively embedded into systems, with no single person or action to blame. This type of racism operates under the surface, making it harder to identify, especially by those who are not harmed by it.
Due to its invisible nature, it is important to illuminate the disadvantages posed by structural racism. Just because we have come a long way in the past sixty years does not mean the work is done. Structural racism, and the racial hierarchy it perpetuates, continue to impact the everyday lives of people of color in the United States. Minority groups and their advocates have come to realize that giving all people the same resources or treatment is not a sufficient solution. Instead, it is necessary to view these issues through an equity lens which acknowledges that different groups have different needs and circumstances that must be addressed before equality can be achieved. Therefore, in the pursuit of racial justice, policies that shape our educational, housing, health, criminal justice, and government institutions must be viewed through such a lens.
Racial Gerrymandering: Losing One’s Voice
Jones explains institutional racism in two ways: as disparities in material conditions, and in access to power. Material conditions may be more apparent to the average observer. Prevalent systemic disparities manifest in public schools, employment opportunities, and housing accessibility. We can visibly see when a neighborhood is in despair or when a particular group faces higher unemployment rates. Though less obvious, access to power may be more detrimental over time. Voter enfranchisement may decrease power disparities and empower minorities to change material disadvantages. But what happens when people of color lose their voice?
The practice of gerrymandering, dividing a territory on a map into election districts that produces unfair results that favor one political party over another, ensures diminished voting power and representation for minority groups. Boundaries on a map can disadvantage people of color by splitting them up, condensing them into a small number of districts, or placing them within districts with higher proportions of the majority. The Voting Rights Act of 1965 prevented this practice until various Supreme Court cases made it easier for states to pass
discriminatory voting laws and maps without federal approval. Regardless of the method each state chooses every decade, these strategically drawn borders continue to uphold structural racism.
Gerrymandering has been a significant issue in Michigan. In 2010 following the redrawing of districts after the census, Republican legislators halted the passage of several bills aimed at making registering to vote and casting a ballot an easier process. Eight years later, Proposal Three was passed when the American Civil Liberties Union led a coalition of voting rights groups. This initiative added provisions to the state constitution that allowed people to receive an absentee ballot without an excuse and granted Michiganders the option of same-day registration. Following the success of this initiative, Voters Not Politicians addressed gerrymandering directly by enacting an Independent Citizen Redistricting Commission to develop district borders instead of those with partisan interests.
In 2022, almost 60% of Michigan voters supported another ballot initiative, building momentum on previous successes. Proposal Two included provisions that required a minimum of nine days for early voting and election audits to have a public audience. It also made illegal “harassing, threatening, or intimidating conduct,” including laws and regulations that have “the intent or effect of denying, abridging, interfering with, or unreasonably burdening the fundamental right to vote”. There is ongoing debate about how to enact these provisions, with discretion given to each municipality. Inconsistencies across the state may impact minority communities differently.
Despite some success with citizens setting the agenda via ballot initiatives, gerrymandering is still an issue. Advocates in other battleground states like Pennsylvania, Arizona, and North Carolina have also been working to implement ballot initiatives to ensure voting equity. Meanwhile, Alabama has had their voting maps struck down by the Supreme Court twice as of September 2023 after they were manipulated to generate only one district with a Black majority. People in positions of power continue to push back against inclusion of all voices which has consequences.
Health Outcomes of Political Disempowerment
How have gerrymandering and other voting restrictions negatively impacted the health of people of color? It is important to understand the social determinants of health to make the connection between civic engagement and health. This concept highlights the broader social systems that drive individual inequalities. Policies and social norms create a stratified structure, exposing groups to different risk factors that shape their well-being. Addressing these disparities requires an equity-focused, systemic approach. Factors such as the built environment, family dynamics, level of education, economic opportunity, pollution, access to nutrition, and stress processes can disproportionately affect marginalized groups, who have fewer opportunities and resources to impactfully address upstream factors.
When you consider the WHO definition of health–“a state of complete physical, mental, and social well-being”–it is true that a lack of civic participation would not result in good social health. But how does that manifest physically? While life expectancy declined during the
COVID-19 pandemic across the board, white Americans’ life expectancy (76.4 years) at the end of the pandemic was still higher than Black Americans’ pre-pandemic life expectancy (74.8 years before declining to 70.8 years). More Hispanic and non-Hispanic black people were hospitalized than white people for COVID, but even beyond the public health emergency, minority groups were more likely to die from heart disease and childbirth than their white counterparts. Studies continue to show a clear divide in health outcomes, and it is clear why this occurs under a non-representative government.
Social and economic divides perpetuate the disparities in mortality and life expectancy. The Center for American Progress has published several reports that describe how gerrymandering impacts advancements in gun control reform and ensures that many people of color remain uninsured. Issues like these that disproportionately impact minority racial groups are reinforced by voter disenfranchisement. Health equity is not a feasible goal when the system is rigged. Even when people are driven to vote for their representatives or specific policy measures, gerrymandering manipulates their voice to serve the agenda of those in power rather than those who lack it.
Gerrymandering is an efficient perpetrator of structural racism because it limits access to power, thereby maintaining disparities in material conditions, impacting health outcomes. Political parties in power can utilize gerrymandering to ensure the election of their party and then use that position to make it more difficult for people of color to cast a vote in future elections, creating a vicious cycle of disenfranchisement. Giving minority groups a voice in government processes is the only way to ensure policy advances their health and well-being.
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Biography of Author
Farah Pitcher is a second year MPP candidate at the University of Michigan’s Ford School of Public Policy. Her interests include gender & race equality, and technology policy
Edited by: Sam Lynch, MPP ’26 // Aiswarya Padmanbhan, MPP’25 // Amaya Fox, MPP ’26
